Provider Demographics
NPI:1518464692
Name:BUYCO, SZARISSE (PHARMD)
Entity Type:Individual
Prefix:DR
First Name:SZARISSE
Middle Name:
Last Name:BUYCO
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2438 AVALON LN
Mailing Address - Street 2:
Mailing Address - City:MANTECA
Mailing Address - State:CA
Mailing Address - Zip Code:95337-2206
Mailing Address - Country:US
Mailing Address - Phone:209-762-2695
Mailing Address - Fax:
Practice Address - Street 1:2040 E. MARIPOSA RD.
Practice Address - Street 2:
Practice Address - City:STOCKTON
Practice Address - State:CA
Practice Address - Zip Code:95205
Practice Address - Country:US
Practice Address - Phone:209-465-4167
Practice Address - Fax:209-465-4873
Is Sole Proprietor?:No
Enumeration Date:2018-04-06
Last Update Date:2021-10-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA77608183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist